The disclosure is directed to a surgical cranial drape, probes for mapping brain of a subject and their methods of use. Specifically, the disclosure is directed to a sterile surgical cranial drape embedded with electrodes; probe systems for mapping brain regions using evoked electrophysiological responses; and their methods of use in combination or separately.
In recent years, patients or any subject undergoing a surgical procedure is generally at least partially covered by a surgical drape. The surgical procedure is often performed through a fenestration (which can be a window, slit, or other opening) in the drape. It is important for surgical draping to provide an aseptic field about the central operative area. It is common practice for many types of surgery to cover the patient and operating table with a sterile drape in such a way that only the portion of the body upon which surgery is to be performed is presented to the care provider. The drape should therefore conform to the contour of the operative area to ensure that a sterile surgical field is maintained throughout and until the procedure is completed.
Likewise, in many surgeries involving the central nervous system (CNS), electrodes can be used as part of the surgery to either/or monitor, treat, stimulate and diagnose the subject, or in certain circumstances, to conduct research. For example, the placement of intracranial strip and grid electrodes for recording cortical electrocorticography (ECoG) has become an important component in the workup of patients who are considered for resective epilepsy surgery. Those can be electroencephalography (EEG) electrodes recording. Also, intra-operative electromyographic monitoring of the lower cranial motor nerves (LCN IX-XII) in skull base surgery is done using electromyographic electrodes (EMG).
Moreover, electrophysiological monitoring of selected neural pathways of the brain, brainstem, spinal cord and peripheral nervous system has become mandatory in some surgery of the CNS where preventable neural injury can occur. Likewise electrodes may be used in any other invasive procedure requiring that could be assisted by somatosensory evoked potential measurement and mapping.
For example, in deep brain stimulation (DBS) done pre or intra surgery in respective epilepsy surgery, a deep electrode can be inserted to the brain and physiological response measured. Currently, the surgery is performed on awake patient in order to enable a treating physician to access patient's responses and evaluate positioning of the electrode based on known patterns, in order to reach a target area in the brain for electric stimulation or any other surgical treatment.
The positioning of the electrodes is important for reaching a specific target in the brain for diagnostic, research and healing purposes, e.g. for extra cellular or trans-cranial recording from the brain and the nervous system as well as in functional neurosurgery or other biological tissue samples.
Accordingly, there is a need for a sterile surgical cranial drape embedded with electrodes, together or separate with an electrode system for mapping brain regions using evoked electrophysiological responses that can be used on sedated patients during selected procedures.